The mid-hill region of Nepal is experiencing a heavy burden of climate change impacts. Changing rainfall patterns, low crop yields, increased diseases and parasites in animals, drying drinking water sources, forest degradation, and declining river discharges are some of the major climate change impacts in the region. Local communities have adapted to these impacts, but in a very limited scale and with minimal scientific rigor. Comprehensive multidisciplinary research, community capacity-building, and the implementation of appropriate policy measures for climate change adaptation are urgently needed.